AB0938 A new screening tool for Psoriatic Arthritis in Psoriasis Patients: TurPAS
Authors: G. Ayan, G. Hatemi, G. Can, M. Bektaş, A. Ozdede, N. Akdogan, B. Yalici-Armagan, E. Oksum Solak, S. Yazici, E. Ozsoy Adisen, N. Atakan, E. Bulbul Baskan, M. Borlu, B. Engin, V. Hamuryudan, M. Inanc, S. Kiraz, F. Onen, S. Ugurlu, S. Yayli, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2022)

Background Psoriatic arthritis (PsA) is a heterogenous disease with different disease manifestations. Several tools have been developed for screening of PsA in patients with psoriasis with variable performances. An optimal screening tool for PsA is still an unmet need. Objectives We aimed to develop a new screening tool in Turkish which could detect different domains involved. Methods A core group was determined including 11 rheumatologists/10 dermatologist and a systematic literature review on PubMed until 15 August 2020 using the keyword ‘psoriatic arthritis` was performed. The review revealed tools named PEST, PASE, EARP, STRIPP, SIPAS, SIPAT, TOPAS-II, GEPARD, PASQ, CONTEST, A novel, short, and simple screening questionnaire. Each item of those tools were included in the Delphi set. After the 3 rounds of Delphi, a new set of screening questionss was developed. Results Overall 85 items were inquired, including questions on joint, dactylitis, enthesitis, back, skin-nail domains as well as morning stiffness, function, treatment and others for the first round of Delphi. Seventeen experts (9 dermatologists/ 8 rheumatologists from the core group) and fifteen patients (Female/Male= 9/6) answered the Delphi (mean (SD) age of 39.3 (10.9) participated to the first round. The involvemet types were peripheral (73.4%), axial (40%), entheseal (33.4) and dactylitis was present in 14% of the patients. As a result of this first evaluation, 44 out of 85 questions were selected and carried to second round The distribution of these questions was as follows; joint question n=13, skin and nail involvement n=6, dactylitis n=5, morning stiffness n=5, axial n=3, enthesitis n=2, general questions n=5. These questions were sent to the members through rheumatology and dermatology societies. In total, 85 rheumatology specialists and 48 dermatology specialists answered the questions in the second round. At the second tour, the number of questions was reduced from 44 to 22. The distribution of the questions was as follows; Skin and nail involvement n=5, dactylitis n=3, joint question n=2, axial involvement n=2, morning stiffness n=2, axial involvement and morning stiffness n=2, enthesitis n=1, general questions n=5. A consensus meeting was held to discuss 22 questions determined at the end of the second round within the initial core group. Each question was handled one by one, some of the questions were combined, if necessary, adapted to Turkish. The tool was given its final form. The final version of the questionnaire consists of 6 questions. (Table 1). Table 1. The new screening tool Domain Turkish version English version Joint El/ayak parmaklarinizda ya da herhangi bir ekleminizde hiç şişlik veya ağri oldu mu? Have you ever had swelling or pain in your fingers/toes or any of your joints? Dactylitis Resimde gösterildiği gibi el veya ayak parmağinizda sosis şeklinde şişlik oldu mu? Have you had a sausage-shaped swelling on your fingers or toes as shown in the picture? Enthesitis Topuk ağriniz olur mu? Do you have heel pain? Axial involvement and morning stiffness Belinizde, sirtinizda veya boynunuzda istirahatle artan, özellikle sabaha karşi kötüleşen veya sabahlari hareketinizi kisitlayan ağriniz olur mu? Do you have pain in your lower back, back, or neck that increases with rest, worsens especially in the morning, or restricts your movement in the morning? Drug use Eklem şikayetleriniz için zaman zaman ilaç kullanir misiniz? Do you take medication for your joint complaints from time to time? History of rheumatic disease Size daha önce iltihapli romatizma tanisi konuldu mu? Have you ever been diagnosed with a rheumatic disease before? Conclusion A new screening tool targeting different domains in Psoriatic disease was developed in Turkish. While cultural differences play an important role in screening, we believe that the first tool developed in Turkish will be helpful in clinical practice and research settings. Further assessments will be done to understand its validity and reliability within a large cohort of psoriatic patients. Disclosure of Interests None declared